The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

Recurrent Gynandroblastoma with Juvenile Granulosa cell tumor, a very rare ovarian tumor in a 29-year-old patient: A case report

Document Type : Case report

Authors
Mehran Toqtamesh 1
Amir-Hossain Jafariyan 2
Zahra Akbari 1
Helena Azimi 3
Yasser Hasanzadeh 1
Hossein Bozorgi 4
1 Resident, Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Professor, Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Gynecologist, Fellowship of Gynecologic Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Resident, Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
10.22038/ijogi.2024.79085.6053
Abstract
Introduction: Ovarian sex cord stromal tumors present with ovarian masses and symptoms resulted from increased hormone secretion. Gynandroblastoma is a rare tumor consisting of two components: granulosa cell tumor and Sertoli or Sertoli-Leydig cell tumor. In this study, a rare case of recurrent gynandroblastoma consisting of Juvenile Granulosa cell tumor and Sertoli cell tumor is reported.
Case Presentation: A 29-year-old woman referred to a medical center in Turkmenistan with irregular menstruation and spotting for one year and progressive abdominal pain for the past four months. A mass in the left ovary was reported on CT scan. The patient underwent left salpingo-oophorectomy surgery, and one pathologist diagnosed Granulosa cell tumor, while another diagnosed Androblastoma. 18 months later, the patient underwent laparotomy due to abdominal pain and an intra-peritoneal mass based on MRI. The pathologic diagnosis was Androblastoma. The patient came to Iran to continue treatment and after reviewing the pathology slides of both surgeries, a neoplastic lesion composed of Juvenile Granulosa cell tumor (70%) and well differentiated Sertoli cell tumor (30%) was found, establishing the recurrent Gynandroblastoma.
Conclusion: Inadequate sampling of the tumor specimen and lack of sufficient accuracy in microscopic examination easily lead to the misdiagnosis of Gynandroblastoma. All patients with this tumor should be periodically followed up for several years in terms of recurrence. Furthermore, genetic screening for DICER1 mutation is important.
Keywords
Granulosa Cell Tumor
Ovarian Gynandroblastoma
Sertoli-Leydig Cell Tumor
Sex Cord-Gonadal Stromal Tumors
Subjects
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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 27, Issue 5
July 2024
Pages 77-83